Congestive heart failure is one of the major causes of mortality and morbidity in the United States, affecting more than 2 million Americans. Pharmacologic therapy has prolonged survival and improved the quality of life for many patients. For cardiac patients who do not respond to conventional treatments, heart transplantation is an effective treatment. However, the shortage of donor hearts limits its application. Mechanical assistance--in the form of the intraaortic balloon pump (IABP)--has become commonplace for the treatment of acute heart failure. But to date, no forms of mechanical assistance for chronic heart failure (CHF) are commercially available.
During the last decade, left ventricular assist (LVA) systems have been used as a bridge to a heart transplant. These systems take over all the work of the heart and have been used for more than a year in many patients who have then gone on to be transplanted. The success of this prolonged cardiac support has led to ongoing clinical trials to evaluate the use of LVA systems as an alternative to medical treatment.